Nursing Makes Nurses Less Empathetic

Irony alert! The best way to decrease empathy in nurses, apparently, is to actually practice nursing. A new study of nursing students found that

as students gained more clinical exposure, they demonstrated a much greater decline in empathy scores over the year than did those with limited clinical experience during that year. This finding extended to students with previous work experiences in the clinical setting, who also evidenced declines in empathy of practical importance. . .

The study indicates the usual suspects in this decline of empathy: lack of time to empathetically interact with patients, lack of support, lack of role modelling, focus on the technical aspects of nursing and so on. It concludes: “[U]ntil the art of nursing is recognized as a necessary criterion for successful completion of coursework and as important as passing an exam, students will likely continue to demonstrate behaviors that make them good technicians but not necessarily very good nurses.”

Ouch.

But I’m not very surprised. I was speaking to a friend the other day who is a clinical instructor for a certain university-based nursing program in Toronto. She told me of the open and enormous contempt the academic instructors at this university have for the clinical instructors (the majority of whom are bedside nurses as well) and by extension, for bedside nursing in general. (This isn’t the first time I have heard this, and I have experienced this myself when I was a clinical instructor.) It isn’t a large leap to suggest what we esteem in bedside nursing, i.e. empathy and compassion, are devalued in the same way, and that negative attitudes are passed on to students.

The rot, it seems, begins early. I would be interested to know the experience of other clinical instructors, or new graduates. Or am I just talking through my hat?

I have had too many jobs for which Managers pushed and pushed for increased productivity. The expectation is that we will please patients at the same time, and when patients complain of feeling rushed, we are disciplined. Quantifying good nursing CARE and empathy always has been a challenge; one I have never known CEOs and managers to attempt. No wonder there is so much early attrition from clinical nursing. Too many of my grad school classmates have struggled with the same disappointments. How do we encourage a real dialogue with the “bottom-liners” and the care-givers?

I was fortunate enough to go to a school where most of the professors were still bedside nurses as well. I think it had a huge impact on my nursing career, because they showed the importance of bedside nursing and empathy. We took several courses on the art of nursing, and empathy and what it meant to nurses. Looking back to when I was a new grad, I am more cynical now, perhaps because I’ve seen a bit more, and see how people manipulate the system. That being said, I feel I’m still empathetic, I’m just a bit more realistic.

I had a patient situation once where the primary care giver/wife of a contracted, elderly alzheiner’s patient was venting about her lack of support from family, community services, frustration with the healthcare system, and how busy the nurses are in the hospital. While I was listening the charge nurse that day called over head that there was an I service meeting. I didn’t come immeadiately and she stormed over to thr patient room telling me I needed to come to the meeting. As this woman was crying I felt that if I left her for an Inservice on new patient gowns or something asanine, I would be validating every issue she had. She needed someone to vent to. She wasn’t rude or offensive; she was exhausted and has watched her husband slip away slowly for 10 years. I got in trouble after for not attending the inservice but felt better for it in the end. It is in those rare moments where we can and do choose to stay at the beside, despite the workload demands and people trying to pull us away that we take control of our caring and compassion and do not let managers, admin whoever take it away
from us. No matter how big or small the issue.

Great job! I think managers have to advocate for time, staff and supportive resources so RNs at the bedside can listen and work a reasonable, SAFE pace.

Saying, “No”, “I can’t work overtime tonight”, “I need more help”, “Dr. that’s the wrong leg!” are all examples of taking care of ourselves and our patients. The more of us who are respectfully assertive will help make care safer and kinder.